POMS Reference

DI 11055: Supplemental Security Income (SSI) Disability Cases

TN 64 (09-09)

A. Introduction

In initial claim situations when the claimant's whereabouts are unknown or the claimant does not wish to pursue the Supplemental Security Income (SSI) claim, the field office (FO) must close out the claim appropriately. An SSI denial is usually preferable to a withdrawal.

For claims associated with a Certified Electronic Folder (CEF), see Processing FO Determinations DI 81010.140.

References:

  • SI 00601.140, Closeout Failure to Pursue Supplemental Security Income (SSI) Eligibility (N17)--Initial Claims

  • SI 00601.110, Closeout – Failure to Cooperate (N18) – Initial Claims

B. Policy when a claimant cannot be contacted or Whereabouts Unknown (WU)

1. Unable to contact the claimant

When you cannot contact the claimant despite all reasonable efforts, including a personal contact at the claimant’s residence, record the efforts made, evaluating the claim based on evidence in file.

2. Claimant's WU

If you cannot locate the claimant at the last-known address, make reasonable efforts to locate him or her, including contacts with the post office, neighbors, physician, and others.

Record your efforts to locate the claimant and evaluate the claim based on evidence in file.

C. Procedure when the entire file is in the FO and no medical evidence is submitted

If the entire file is in the FO and the claimant's whereabouts are unknown, or if you are unable to contact the claimant; and the claimant has not presented any medical evidence, deny the claim using the appropriate closeout procedures found in SI 00601.110. An SSA-831 is not required.

Reference:

DI 11018.005, Claimant Fails to Cooperate (FTC) - Claimant's Whereabouts Unknown (WU)

D. Procedure when the entire file is in the FO and medical evidence is submitted

If the claimant submitted medical evidence to the FO, send the claim to the Disability Determination Services (DDS) in accordance with DI 11055.035. The DDS prepares a disability determination based on the available evidence.

NOTE: The DDS cannot make a medical determination in cases involving unresolved substantial gainful activity (SGA) issues.

E. Procedure when a certified electronic folder (CEF) or file is in DDS

If the claim is at DDS, contact the DDS to advise them that the claimant's whereabouts are unknown. The DDS prepares a disability determination based on the available medical evidence.

F. Procedure for discontinuing development when a claimant does not wish to pursue the claim

A non-medical denial may be proper in situations in which the claimant may indicate, either by actions or by a written or verbal statement, that they do not wish to pursue the claim. If it appears that the reason the claimant may not wish to pursue the claim is a result of difficulty in securing evidence or difficulty communicating, advise the claimant that you can assist them. The following instructions explain the necessary procedures when a disability file is in the DDS or in the FO:

1. Disability file in the DDS

If the disability file is in the DDS, contact the DDS to advise them that the claimant does not wish to pursue the claim. The DDS completes any required development, prepares the Form SSA-831 (Disability Determination and Transmittal) by entering decisional data, and returns the case to the FO.

2. Disability file in the FO

If the FO did not transmit the disability claims folder to the DDS and the claimant does not wish to pursue the claim, process the claim as a technical denial.

For MSSICS claims, annotate "claimant does not wish to pursue claim" on the SSA-3367, Disability Report-Field Office, Remarks section. For non-MSSICS claims, use Form SSA-831, Item 11, Remarks.

Reference:

DI 81010.140, Processing Field Office (FO) Determinations